Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2016
Randomized Controlled Trial Multicenter StudyA Multicenter Evaluation of a Closed-Loop Anesthesia Delivery System: A Randomized Controlled Trial.
Closed-loop systems for anesthesia delivery have been shown to outperform traditional manual control in different clinical settings. The present trial was aimed at evaluating the feasibility and efficacy of Bispectral Index (BIS)-guided closed-loop anesthesia delivery system (CLADS) in comparison with manual control across multiple centers in India. ⋯ Our study in a multicenter setting proves the consistently better performance of automated anesthesia drug delivery compared with conventional manual control. This highlights an important advantage of an automated system for delivering standardized anesthesia, thereby overcoming differences in practices among anesthesiologists.
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Anesthesia and analgesia · Jan 2016
ReviewEfficacy Outcome Measures for Procedural Sedation Clinical Trials in Adults: An ACTTION Systematic Review.
Successful procedural sedation represents a spectrum of patient- and clinician-related goals. The absence of a gold-standard measure of the efficacy of procedural sedation has led to a variety of outcomes being used in clinical trials, with the consequent lack of consistency among measures, making comparisons among trials and meta-analyses challenging. We evaluated which existing measures have undergone psychometric analysis in a procedural sedation setting and whether the validity of any of these measures support their use across the range of procedures for which sedation is indicated. ⋯ Certain scales, for example, those requiring motor stimulation, are unsuitable to evaluate sedation for procedures where movement is prohibited (e.g., magnetic resonance imaging scans). Further work is required to evaluate existing measures for procedures for which they were not developed. Depending on the outcomes of these efforts, it might ultimately be necessary to consider measures of sedation efficacy to be procedure specific.
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Anesthesia and analgesia · Jan 2016
Distribution of Injectate and Sensory-Motor Blockade After Adductor Canal Block.
The analgesic efficacy reported for the adductor canal block may be related to the spread of local anesthetic outside the adductor canal. ⋯ The spread of injectate to the popliteal fossa may contribute to the analgesic efficacy of adductor canal block.